Practice Patterns Among Physicians Providing Ketamine Therapy

A recent Yale study (1) gives us a better idea of who is treating patients with ketamine for severe depression in the United States.

Physicians Providing Ketamine Therapy Were Trained in:

The new data seems to contradict the conventional wisdom that, “most of the current ketamine clinics in the United States are run by anesthesiologists rather than psychiatrists.” (2)

Diverse Clinical Practices

Surveys were found via a web search for clinicians using ketamine to treat psychiatric disorders. 76 providers were contacted, with responses were received from 57 (75.0%).

Type of Clinic

73.7% in private practice

14% in academic settings

8.8% in Health Maintenance Organizations

Clinic Setting

73.7% office-based

21.1% hospital-based setting or surgical/procedural suite

Route of Administration

87.7% IV

22.8% oral

19.3% intranasal

Dosing (IV)

44.0% 0.5mg/kg

12.0% between 0.5-1.0mg/kg

14% between 0.5-3.0mg/kg

Treatment Maintenance

89.5% of clinicians reported offering ketamine on a continuation/maintenance basis (defined as a time period greater than 1 month).

Providers reported the average frequency of maintenance treatments as:

29.8% monthly

21.1% once per 3 weeks

12.3% once per 2 weeks

15.8% less than monthly

According to lead researcher, Dr. Samuel Wilkinson, clinicians reported efficacy rates similar to that seen in research studies. (3)

“This is not the same quality of official rating scales, but in terms of meaningful response, most said between 60% and 80%, which is close to the efficacy we see in most clinical trials.”

Ketamine Therapy: ‘Train has Left the Station’

The number of ketamine clinics has exploded in recent years.

Number of Providers of Ketamine Therapy

“While there is controversy regarding the use of ketamine for depression outside of the realm of research, I am arguing that this train has left the station,” said Dr. Wilkinson.

“There is clearly excitement over the real and rapid effect, combined with the desperation of patients who are not responsive to conventional treatments,” he said.

“If we partner with each other and with community providers who are offering ketamine for depression, we can learn more about it. There are clearly a large number of patients being treated with this, and we need to be able to pool our data and learn something.”